Soumya Swaminathan and colleagues call for increased funding and regional collaboration to boost research relevant to disease and health priorities in South Asia

Magnetic Resonance Imaging (MRI) has been the primary imaging modality and has revolutionized the imaging of brain tumors. MRI can display accurate multi planer imaging without interfering of adjacent structures specially for posterior fossa mass lesion. MRI is the imaging modality of choice for cerebollo-pontine (CP) angle Schwannoma. The study was performed to determine, the diagnostic accuracy of MRI in the evaluation of intracranial extra axial CP angle Schwannoma. MRI scan of brain was done on 42 consecutively selected patients referred for the evaluation of CP Acoustic Schwannoma. The age range from 21-60 years and the mean age was 42.85(+9.5) years. Highest incidence of cerebollo-pontine angle (CPA) mass were found 42.86% in 41-50 age group of patients. Male and Female ratio was 1.083:1. The most common presenting feature of the patients with CP angle Acoustic Schwannoma were headache 90.48%. Acoustic Schwannoma is T 1 hypointense 100%, T 2 hyper intense 84.61% and heterogeneously hyper intense 92.30% in FLAIR image. After giving contrast agents, homogeneous enhancement 57.69% and heterogeneous 42.31% cases of Acoustic Schwannoma. Overall 61.54% Acoustic Schwannoma strong contrast enhancement was observed. Dural tail was observed in 26.92% cases. Perilesional edema was observed 38.46% cases. Mass effect was observed in 76.92%. After complete MRI evaluation 61.9% had Acoustic Schwannoma. Histopathologicaly proved cases showed out of all patients Acoustic Schwannoma 59.52%. The overall sensitivity of MRI to diagnose Acoustic Schwannoma were found, Sensitivity-96%, Specificity-88.2%, PPV-92.31%, NPV-93.75% and Acceuracy 92.86%. Test is significant with p<0.0001 level. It is conceivable that MRI is a highly accurate, sensitive and Gadolinium enhanced MRI is more sensitive in detection of acoustic Schwannoma. MR imaging is the study of choice for the examination of the patient of cerebellopontine angle Schwannoma because of its high sensitivity specially after use of contrast material.

Coronavirus disease (COVID-19) is an infectious disease caused by the most recently discovered novel coronavirus, renamed as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). 1 It was unknown before the outbreak began in Wuhan, China, in December 2019. 2 The outbreak was linked epidemiologically to the Hua Nan seafood and wet animal wholesale market in Wuhan, and the market was subsequently closed on 1 January 2020. 3 The virus rapidly spread to all provinces in China, as well as a number of countries overseas, and was declared a Public Health Emergency of International Concern by the Director General of the World Health Organization on 30 January 2020.4 Subsequently, on 11 March 2020, the WHO declared COVID-18 a pandemic.5 It   is the first pandemic caused by a coronavirus. 6 Around the globe, hundreds of thousands have been infected and tens of thousands people died including frontline workforce including physicians, nurses and others. Bangladesh reported its first confirmed COVID-19 case on 8 March 2020, after three people, two men and a woman tested positive for the coronavirus. Two of the infected are recently returned from Italy, and the other one is a female family member of the infected male. On the 18 March, 2020, Bangladesh confirmed the first death from COVID-19. 7 In Bangladesh, till 30 March 2020, 49 confirmed cases and there were five deaths due to COVID-19.8 This pandemic-a global calamity, is not only a health concern, it is a threat to life and livelihoods worldwide. In addition to health, major disruptions are also occurred in business, education, transports and others areas.  It causes interruption in every aspect of day to day life. To prevent and control infections, the immediate challenges ahead are to conduct the tests, isolation of infected cases, tracing of the contacts and quarantine, and appropriate measures for the overseas returnees. An effective risk communication with community engagement is critical to reduce the stigma, fake news, psychological stress. It is essential to bring courage and mental strength of the frontline fighters, and support for the poor and daily wage earners etc. Aimed at preventing and control of SARS-COV-2, government of Bangladesh has already initiated steps including enhancement of public awareness on hand hygiene, respiratory hygiene, social distancing, wearing of masks, avoidance of public gatherings, campaign against myths, fake news and stigma; preparing the health care services including expansion of hospital facilities, training and protective measures for the health workforce and other frontline fighters. Furthermore, steps are being taken conducting RT PCR tests, isolating infected cases, tracing contacts, quarantine the contacts and overseas returnees, and other necessary measures. The government has declared the general holiday in Bangladesh including closure of the educational institutes and office and workplaces, to prevent and control of infections. Necessary steps have been initiated for the social and economic protections of the vulnerable including expansion of the existing social safety net programmes. Aimed at adequate and timely response to the COVID-19, the Directorate General of Health Services (DGHS), the Ministry of Health and Family Welfare, developed a number of guidelines and manuals for   the containment of this pandemic disease. For an effective and timely preparedness and response, the DGHS has developed ‘National Preparedness and Response Plan for COVID-19, Bangladesh’.9 For better response, well-coordinated and cooperated global efforts, including exchange of information, scientific knowledge, research findings, expertise and best practices are important. All countries should implement WHO guidelines and recommendations.  In Bangladesh, the Ministry of Health and Family Welfare alone cannot mitigate this pandemic. Strengthening of the coordinated efforts among the ministries, and effective and timely engagement of the non-government and private sectors are strongly recommended. Intensification of RT-PCR lab tests for case detection, and isolation and management of cases, and to trace the contacts and ensure quarantine, surveillance, and research, serological tests   to detect SARS-CoV-2 specific immunoglobulins (IgG and IgM) to estimate the population exposure, strengthening public awareness and  risk communication, strict implementation of personal hygiene, use of face mask, social distancing  and other measures are thus suggested to prevent and control COVID-19 in Bangladesh. Bangladesh Med Res Counc Bull 2020; 46(1): 01-02

Coronavirus disease (COVID-19) was unknown before the outbreak began in Wuhan, China in December 2019. The virus rapidly spread in different countries across the globe. The World Health Organization (WHO) declared it as a pandemic on the 11th March 2020.1 The pandemic has revealed many areas of public health preparedness those are lacking both in developed and developing countries. Digital interventions provide many opportunities for strengthening health systems.2 It could be a vital resources and could play a critical role in global response to this public health emergency. Digital health is the use of digital information and communication technologies for efficient and timely delivery of health care services, aimed at promoting and protecting the health of the individuals and communities. Furthermore, digital technologies are also being used for conducting monitoring and surveillance of the health programmes, health education, research,  development of human resources including continued professional development,  risk analysis speacially the  risk commucation. Data being generated through services, research, monitoring and surveillance are also used for health management and decision making. Bangladesh Med Res Counc Bull 2020; 46(2): 66-67

Dengue is the most common mosquito-borne, viral disease in the world. Dengue virus is a single stranded positive polarity RNA virus, belongs to the family Flaviviridae. It is transmitted through the bite of an infected female mosquito of Aedes species - mainly   the   species Aedes   aegypti and,   to a lesser extent, Aedes albopictus. This mosquito also transmits Chikungunya, Zika and Yellow fever viruses.1-4 There are 4 distinct, but closely related, serotypes of the virus (DEN-1, DEN-2, DEN-3 and DEN-4). Recovery from infection by one serotype provides heterotypic or cross-immunity to the other serotypes. This is only partial and temporary, lasts only a few months, but homotype immunity is lifelong. For this reason, a person can be infected with a dengue virus as many as four times in his or her lifetime. Subsequent infections (secondary infection) by other serotypes increase the risk of developing severe dengue.1-5 The fifth variant DENV-5 has been isolated in October 2013. DENV-5 has been detected during screening of  viral  samples  taken from a 37 year old farmer admitted in a hospital in Sarawak state of Malaysia in the year 2007.6 The first record of a case of probable dengue fever reported in a Chinese medical encyclopedia from the Jin Dynasty (265–420AD).The first recognized dengue epidemics occurred almost simultaneously in Asia, Africa, and North America in the 1780s, shortly after the identification and naming of the disease in 1779. The first confirmed case report dates from 1789 and is by Benjamin Rush, who coined the term "breakbone fever" because of the symptoms of myalgia and arthralgia.7 Haemorrhagic dengue was first recognised in the 1950s during dengue epidemics in the Philippines and Thailand. 8 The incidence of dengue has grown dramatically around the world in recent decades. A vast majority of the cases are asymptomatic and hence the actual numbers of dengue cases  are  underreported  and many cases are misclassified. Dengue is common in more than 100 countries around the globe, with its endemicity in Asia, the Pacific, Africa and the Latin American countries. Forty percent of the world’s population, about 3 billion people live in the areas  with a risk of dengue. Annually, some 400 million people get infected with dengue, with an occurrence of 100 million  clinically apparent infections,  and 22,000 die from severe dengue across the globe. The increasing incidence, severity and frequency of dengue epidemics  are linked  to trends in  human ecology,  demography and  globalisation,  and  may have been influenced by climate change. 8,9 In   Bangladesh,   dengue   occurred   sporadically since 1964.10 Literature shows, the first documented case of dengue like fever occurred in 1964, popularly known as "Dacca fever" which later on serologically proved as dengue fever.11 Bangladesh has been experiencing episodes of dengue fever in every year since 2000. All four serotypes have been detected, with DENV-3 predominance until 2002.12,13 After that, no DENV-3 or DENV-4 was reported from Bangladesh. During 2013-2016, DEN2 was predominant followed by DEN-1 in circulation. Institute of Epidemiology, Disease Control & Research (IEDCR) predicted that  as the  serotypes DENV-3 and DENV-4 are in circulation in the neighbouring countries, they may create epidemics   of   secondary  dengue   in   the   near future in Bangladesh.14  In 2017, reemergence of DENV-3 was identified; subsequently there was a sharp rise in dengue cases from the beginning of the monsoon season in 2018.15 In 2000, dengue attacked 5,551 individuals and the number  of  deaths was  93.  Since  2003,  the death rate has declined gradually, with zero fatalities in subsequent couple of years, but a devastating turn with 10,148 cases and 26 deaths in 2018. In 2019, during January to July, number total cases were 18,484, with 57 deaths.16 Directorate General of Health Services conducts periodical (Pre-monsoon, Monsoon and Post- monsoon) Aedes survey to estimate the vector density of the mosquito.  The monsoon survey (18-27 July 2019) of 100  sites  of 98  wards in Dhaka city both North and South revealed that the number of adult aedes mosquito was increased by 13.52 folds, in compare  to  the  pre-monsoon    (3-12 March 2019) survey.17  The aedes larvae were also increased by 12.5 folds in this period. Breteau Index (BI) was considered in the study. Report shows that the BI was more than  20 in 57% and 64% of total wards in Dhaka North and Dhaka South respectively.  Furthermore,  in terms of House Index (HI) or percentage of houses infested, 75% and 83% of total wards in North and South city respectively having HI more than 5.17  Furthermore, recent  studies  show that  mosquitoes  have grown resistant,  and  how  certain  insecticides  are completely ineffective against them.18 Considering the situation, the Ministry of Health and Family Welfare, has taken commendable steps including training on case management for nurses and doctors across the country, review of the national guidelines on case management, expansion of dengue services along with increasing bed capacities in hospitals, strengthened  mass  awareness  with  special attention  to  the  school  children  and  the community  people,   ensuring   availability   of dengue diagnostic kits, diagnostic services at free of cost in public health facilities and fixed and reduced rate in private sectors, strengthening collaboration  with  city  corporations, municipalities   and other agencies both in public and private sectors and development partners.  Prevention and control of dengue in Bangladesh, is not a sole responsibility for any single ministry and or its agencies. It needs effective and timely coordination, collaboration and partnership, among all the concerned ministries and their agencies, led by the Ministry of Health and Family Welfare. Furthermore, strengthening of the existing efforts including capacity building and resource mobilisation, and integrated surveillance, sustainable vector control, optimum and active community participation, and adequate monitoring and periodic evaluation throughout the year across the country, considering it an endemic disease, are strongly recommended.  Bangladesh Med Res Counc Bull 2019; 45: 66-68